Thoughts, comments, news, and reflections about healthcare IT from Microsoft's worldwide health senior director Bill Crounse, MD, on how information technology can improve healthcare delivery and services around the world.

Doc in the box now out of the box

Doc in the box now out of the box

Our current model for healthcare delivery does a reasonable job meeting the needs of people in developed nations around the world. However, even in those nations that provide good care for citizens there are growing concerns about aging populations, the increasing incidence of chronic disease, and shortages of skilled healthcare professionals. Then consider the other 5 billion people in the world, many of whom have little or no access to healthcare services. How do we scale the number of healthcare professionals and required services to meet the needs of all people on earth?

One of the things that has been said about the Internet, healthcare consumerism, social networking, and Web 2.0-3.0 technology is that we may be witnessing the evolution of systems that will one day help us redistribute healthcare resources. In a small way you can see this playing out today. India has a surplus of radiologists. We are now able to redistribute these skilled professionals using web communication and collaboration technologies so they can interpret medical images from around the world. Such a plan not only redistributes the available pool of radiologists, but improves service continuity across global time zones. That’s just one small example. You’ll find lots of other examples in previous posts on HealthBlog. Last week’s post about work going on in Hawaii using technology and services from American Well and HealthVault is another way to redistribute healthcare professionals and provide greater scale for health information and certain kinds of medical services.

Another example can be seen in work going on at Massachusetts General Hospital. Dr. Ronald Dixon, Director of the Virtual Practice Project at MGH’s Department of Medicine, and his colleagues are working on a kiosk solution that promises yet another approach to help redistribute and scale medical services. The kiosk under development is able to take a patient's medical history and vital signs. It may also provide simple blood tests like glucose and cholesterol. Results coming from a patient’s encounter with the kiosk can be electronically forwarded to a nurse or physician for further evaluation and appropriate intervention. Researchers plan to pilot the kiosk solution later this year in the United Kingdom.

The airlines and banks have done us a huge favor. Everybody in the world who has ever flown on an airplane or used an ATM now knows how to use a kiosk. It may turn out that the kiosk is a perfect way to scale healthcare services in both developed and underdeveloped settings. Imagine a group of healthcare kiosks in every grocery store, pharmacy, post office, or other places people gather. Imagine being connected to healthcare experts around the world, 24 hours a day. And if you don’t quite buy into the kiosk idea, let me remind you that the television in your living room is becoming a fully digital device connected to broadband. It doesn’t take any stretch of the imagination to see how that device in your living room may one day also become a portal to all kinds of health information and medical services from the comfort of your very own home.

Health kiosks have tremendous potential. As more people get familiar with computers and digital interfaces, automation will improve care delivery. The use of automated services that leverage tailored messaging can have a significant public health if it's delivered properly.

SoloHealth recently developed EyeSite, a vision testing kiosk. The average person only visits their eye doctor every 3-4 years. Why? because most people do not realize the importance of a regular eye exam and they don't have time to go.